Medicare Advantage Plans, also known as Part C, are an alternative way to receive your Medicare benefits. They are offered by private insurance companies that are approved by Medicare.

Original Medicare is a federal program that includes Part A (hospital insurance) and Part B (medical insurance). Medicare Advantage is a private plan that provides all of your Part A and Part B coverage, and often includes additional benefits.

By law, Medicare Advantage Plans must cover all the same services as Original Medicare (Parts A and B). Most plans also offer additional benefits not covered by Original Medicare, such as prescription drug coverage (Part D), vision, hearing, and dental services.

When you enroll in a Medicare Advantage Plan, Medicare pays a fixed amount to the private insurance company each month. The plan then provides your coverage and determines your out-of-pocket costs, such as copays and deductibles.

To be eligible, you must be enrolled in both Medicare Part A and Part B, and you must live in the plan's service area.

Yes, insurance companies cannot deny you coverage or charge you more for a Medicare Advantage Plan based on a pre-existing condition (except for End-Stage Renal Disease).

An HMO plan typically requires you to use doctors, hospitals, and other providers within the plan's network, except in cases of emergency or urgent care. You will likely need to choose a primary care provider and get a referral to see a specialist.

A PPO plan has a network of doctors and hospitals, but it allows you to see out-of-network providers for a higher cost. You generally do not need a referral to see a specialist.

Yes, even if you have a Medicare Advantage Plan, you are still responsible for paying your Medicare Part B premium.

Some Medicare Advantage Plans have a monthly premium in addition to your Part B premium, while others have a $0 monthly premium. The cost depends on the plan and the benefits it offers.

This is the most you will have to pay for covered Part A and Part B services in a calendar year. Once you reach this limit, your plan will pay 100% of the cost for the rest of the year. Original Medicare does not have an out-of-pocket maximum.

Generally, costs for prescription drugs covered under Part D do not count toward your out-of-pocket maximum for medical services.

A formulary is a list of prescription drugs that a Medicare Advantage Plan covers. It's important to check the formulary to ensure your medications are on the list.

There are specific enrollment periods, including the Initial Enrollment Period when you first become eligible for Medicare, the Annual Enrollment Period (October 15 to December 7), and the Medicare Advantage Open Enrollment Period (January 1 to March 31).

The AEP runs from October 15 to December 7 each year. During this time, you can join a Medicare Advantage Plan, switch to a new one, or switch back to Original Medicare.

The MA OEP runs from January 1 to March 31. This period is for individuals who are already in a Medicare Advantage Plan and want to switch to a different Medicare Advantage Plan or back to Original Medicare.

No, it is illegal for an insurance company to sell you a Medigap policy if you are enrolled in a Medicare Advantage Plan.

This depends on the plan type. HMO plans typically require a referral from your primary care provider, while PPO plans do not.

SNPs are a type of Medicare Advantage Plan that is designed for people with specific diseases or characteristics, such as those with chronic conditions or those who qualify for both Medicare and Medicaid.

You can make changes to your plan during the enrollment periods mentioned above. You may also be eligible for a Special Enrollment Period if you have a qualifying life event, such as moving to a new service area.